While the thought of advocating for yourself in medical spaces can feel daunting, it’s important to remember your rights as a patient. If your GP agrees that you need to be referred to a specialist, you have the legal right to choose an appropriate healthcare provider to carry out your treatment. This right is enshrined in the NHS charter and must be honoured.
Your GP understands that they have a duty to take you seriously and help you access the support you need in a timely manner. However, if they question or refuse your Right to Choose, it may be because:
- They may not be aware of it
- They may have concerns about funding.
In both cases, your Right to Choose is not disqualified, and you can direct your GP to the NHS information on patient choice. However, there are a few valid, clinical reasons why your GP may reject your request.
When can a GP refuse my Right to Choose request?
- You are non-verbal and/or selectively mute
- You are not fluent in English
- You have a diagnosis of global development delay or a diagnosed intellectual disability (IQ below 70)
- You are currently receiving treatment for an active eating disorder, and/or in active family-based therapy or eating disorder therapy
- You are a person who is looked after, or under the guardianship of a local authority
- You are currently receiving treatment for drug or alcohol addiction
- You have experienced a current, or recently (within 3 months) resolved, psychotic episode
- You have a significant visual or hearing impairment
- You are undergoing safeguarding investigations
- You currently have high levels of risk in terms of your behaviour and mental health
- You require emergency treatment
- You have already received care or treatment for the neurodevelopmental condition for which you are seeking an assessment
- You are detained in a hospital under the Mental Health Act 1983, or on a Community Treatment order
- You are seeking a second opinion assessment, and have already been assessed for autism within the last year (this does not apply to assessment for ADHD)
- You are currently serving a prison sentence, or are on temporary release
- You serve in the armed forces
- You have had a head injury, brain surgery, or have a neurological condition that has left you with significant cognitive impairments
- You are unable to look after your self-care needs, or the needs of your dependants (e.g., washing, feeding, not taking prescribed medications).
In some cases, your request may be rejected due to specific requirements from the Right to Choose provider themselves. For example, if you wish to pursue an online assessment with ProblemShared through Right to Choose, your request may be rejected if:
- You do not have access to a laptop or computer (please note that an iPad which is at least 10” in size and can be propped up to be used handsfree can also be used to access our service, but handheld devices such as mobile phones cannot)
- You do not have access to an internet connection in a private place
- You or your child are not willing to conduct the assessment with your camera turned on for the duration of the assessment.
When picking a Right to Choose provider, it’s always important to look at their unique suitability criteria before asking your GP to refer you to them.
Tips for handling your Right to Choose request with your GP
It’s normal to feel a little apprehensive ahead of a discussion with your GP about a Right to Choose referral. The good news is that there are steps you can take to help reduce any potential friction, or simply to boost your confidence:
- Have a digital or paper copy of the NHS Choice Framework to hand during the conversation to show your GP
- Know exactly what you want to say, and use ‘I’ statements to express your needs (e.g. ‘I am experiencing...’, ‘I am seeking an assessment for...’ etc.)
- Ask to be presented with all your options
- Don’t be afraid to take your time and fully process your responses before delivering them.
Please see our ‘How to get a Right to Choose referral from your GP’ article for more information on how to prepare for your first consultation.
If you still feel that you have not been offered a choice
If nothing changes after your initial conversation with your GP, you could consider raising a complaint with your local Integrated Care Board (ICB). It’s their responsibility to ensure that all patients are offered the choices afforded to them under the NHS Choice Framework.
If your local ICB is unable to resolve the complaint to your satisfaction, you're entitled to take your complaint to the independent Parliamentary and Health Service Ombudsman.
How to reduce the chances of your ProblemShared referral being rejected
If you’re planning on asking your GP to refer you to ProblemShared for your autism or ADHD assessment, we highly recommend checking out our suitability criteria before seeking your referral to ensure our service meets your personal circumstances.
Once you’ve completed the suitability criteria check, you’ll be able to access our self-report forms (AQ10 for autism, ASRS for ADHD), which you can complete, print out, and bring with you to your GP appointment.
Please visit our Right to Choose page for more information on our service.
